Individual
PHILLIP ROY LIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236
(313) 343-4370
Mailing address
22101 MOROSS RD, DETROIT, MI 48236-2148
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704263527
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704263527
MI
Other
Enumeration date
12/17/2012
Last updated
07/31/2018
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